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47T PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 12/8/2016 <br /> Permit#: C1612-007 <br /> PROJECT ADDRESS: 2330 E GRAND AVE <br /> DESCRIPTION OF WORK: CONVERT SFR INTO DUPLEX <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: MURPHY RANDALL G NAME: MURPHY RANDALL G <br /> ADDRESS: 2330 E GRAND AVE ADDRESS: 2330 E GRAND AVE <br /> EVERETT,WA, 98201 EVERETT,WA, 98201 <br /> PHONE: PHONE: <br /> EMAIL: EMAIL: <br /> CONTACT: 0 Owner 0 Applicant ❑Other <br /> NAME: MURPHY RANDALL G <br /> PHONE: 4256149451 <br /> EMAIL: <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required? (YES 0 NOrw.0.#: <br /> Notes: /�i /f�'� Associated Bldg./PW Permit#: PW f-0!-O/S <br /> 0" Q PW1 T15 <br /> FIRE SPRINKLER REQUIRED?(by Fire Department/Code) <br /> ❑YES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> ❑ NO <br /> Explanation: 1C r./2 4q, , 1 <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: FIRE SERVICE: <br /> ❑YES—Amount$ 0 YES—Amount$ <br /> 0 Meter Only, 0 Complete Service, Size ❑'/" Detect Meter Only, 0 Fire Service Size <br /> tit NO - NO <br /> Explanation: Explanation: <br /> N(W❑ RPBA Needed at premise?-(Plumbing permit for backflow device needed due to High-Hazard Site per Tim Markham's review) <br /> N(,i-❑Water Department Cost Estimate Needed-(/f yes, PW Reviewer to send cost estimate request to Water Department, attach copy) <br /> Existing Utility Permit#(if applicable): <br /> SEWER FEE? <br /> ❑YES—Amount$ 0 New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> "ENO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> 'OYES—Amount$ 'OmO,°0 0 See Attached Spreadsheet <br /> ❑ NO—No Change of Use/Other �i p��//Explanation: G Sfi�(3000SF-t) ` �'lf'Ll?/X Grf//911/6E OF t" e /i1a�g� ��1 (W- J8/0 ! <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> 18(YES—A ount$ 2/1/001% 0 See Attached Spreadsheet 3 Pw( j(—015 <br /> ❑ NO ($(90—a4�= ain) <br /> ADDRESS LETTER REQUIRED? (If yes(ne assigned address), print out Address Letter from TRAKiT/� Print Menu and include) <br /> �e) <br /> lAYES—TYPE pUPLFiX( gSee Attached Letter — 2 f C/ 44,0"'`"t /let- nia zi r) <br /> ❑ NO <br /> PW Reviewer: 41,67A4 <br /> Date: I//9454/q/ <br /> REVISED 10/11/2016 <br />